Influence of percutaneous endoscopic gastrostomy on gastroesophageal reflux: a prospective study in 68 children

Abstract

Background: Among other complications, the development of or an increase of gastroesophageal reflux (GER) is considered to be associated with percutaneous endoscopic gastrostomy (PEG). However, the few studies performed to date show controversial results.

Methods: Continuous 24-hour pH monitoring was performed prospectively in 68 patients before and at least 3 days after percutaneous endoscopic gastrostomy placement. None of the patients had been treated for gastroesophageal reflux.

Results: The percentage of patients with abnormal test results did not differ significantly before and after PEG insertion (22.1% versus 25%). Nor did the median reflux index change significantly before and after gastrostomy for the whole group of patients (2.6% versus 3.4%). The median reflux index increased significantly (from 1.8 to 5.4) only in patients who underwent PEG implantation in the antrum (n = 9). Clinical signs of GER correlated poorly with the results of pH monitoring.

Conclusions: Data in this study strongly suggest that, in general, percutaneous endoscopic gastrostomy does not provoke gastroesophageal reflux. Results also indicate that placement in the antrum may be unfavorable.